Description

The vertebral arteries are the main source of blood supply to the structures within the posterior fossa. Vertebral Artery Hypoplasia (VAH) is defined as a condition where there is a difference of more than 2 mm in the diameter of the vertebral arteries at the V4 segment [1]. The concept of regional hypoperfusion is associated with unilateral VAH and posterior circulation stroke [2]. The risk of posterior ischemia is related to an increasing degree of VAH regardless of the net flow [3]. We had a 65-year-old male, who presented with Dizziness in our OPD, but history and clinical vestibular examination didn’t lead us to any definitive diagnosis. CEMRI was performed to rule out Central causes of Dizziness, which showed Left Vertebral hypoplasia as the sole cause of the patient’s dizziness. In axial section at V4 segment level, the right vertebral artery was measured 6.03 mm and the Left Vertebral artery was 3.01 mm with a difference of 3.02 mm between 2 sides.

Figure 1: Clinical image

References

1. Katsanos AH, Kosmidou M, Kyritsis AP, Giannopoulos S. Is Vertebral Artery Hypoplasia a Predisposing Factor for Posterior Circulation Cerebral Ischemic Events? A Comprehensive Review. Eur Neurol. 2013; 70(1-2): 78-83. doi:10.1159/000351786.
2. Chuang YM, Chan L, Wu HM, Lee SP, Chu YT. The clinical relevance of vertebral artery hypoplasia. Acta Neurol Taiwan. 2012; 21(1): 1-7.
3. Schöning M, Walter J, Scheel P. Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults. Stroke. 1994; 25(1): 17-22. doi: 10.1161/01.STR.25.1.17.